-Responsible for leading Medical Insurance & B2B functions in NahdiCare Clinics Group.-Executing company’s strategy through managing & achieving annual revenue to ensure business growth, stability, & profitability.-leading: Contracting (corporate), Pre-auth, Claims, Reconciliation, Collection, Credit Accounts, B2B, Telemedicine, HHC, Chronic Disease Management Programs, & Healthcare Projects. -Negotiating, reconciling with payers, & collecting credit payment to ensure high efficiency of revenue cycle management.-Contracting with corporate companies to provide advanced healthcare services & solutions using technology. (Islamic Bank, Jeddah Central Development Company, Ma’aden Company, SNB, Naghi group, & others).-Established Telemedicine & HHC business units & managing operations to provide the service 24/7 in all cities of KSA.-Secured B2B deals to inject the virtual experience with required medical services to ensure delivering comprehensive services in all cities through contracting with central labs, X-ray providers, physiotherapy centers, and others. -Reached more than 1 million guests in 2023 (walk in & virtual).-Created Insurance policy & procedures \ guidelines based on regulations & market best practice to upgrade service quality & improve claims cost efficiency.-Automated ‘’Claiming and billing‘’ process in clinic system to collect all claims documents in few hours (more than 50K claims monthly claims). -Automated ‘’Adding Policy‘’ service in clinic system & application to reflect insurance policy details within less than 30 seconds, and to minimize the waiting time of providing the service & to prevent technical rejection in claims statements.-Built Joint Business Plan with Magrabi Optical for mutual benefits.-Leading a team of 22 members across KSA (direct & indirect reportees).-Structured the team into centralized & decentralized divisions to manage different revenue stream channels.-Setting up the team’s objectives, targets, and KPIs.

Key Responsibilities- Responsible for a book of 88 healthcare provider accounts from Bupa Arabia side, with total amount of 620M SAR, in 2020, including Hospitals, Polyclinics, Pharmacies, Dental Centers, Specialized Centers, Optical shops, Hearing Aid Centers, and Physiotherapy Centers.- Responsible for Cost Control thru Unit Cost\Risk Cost management.- Responsible for Service utilization management and analysis. - Commercial settlements and Negotiations with cost efficiency\savings.- Claim by Claim settlements with abuse and fraud examination.- Key player in Medication Strategy team.- Provider Network Management.- Automation and Digitization \ System Integration with providers.- Key Achievements/Projects- Built successful partnerships with top strategic partners. (Nahdi Pharmacies & Magrabi Group).- Making slim fast deals to achieve forecasted savings. - Settlement completion and efficiency based on calculated forecast. - Managed to renew the top providers contracts with minimal/no price increase.- Led the project of Direct Claims Integration with Nahdi Pharmacies, as the first provider in Bupa Network in terms of System Direct Integration. (Claims Level).- Leading the project of Direct Pre-authorization Integration with Nahdi Pharmacies to be the first fully integrated provider in Bupa network, in terms of Direct Pre-Auth integration.- Represented provider relation team in Automation of the payment process, of Late Submitted Batches.

Key Responsibilities- Setting up Dental Guidelines and Dental Protocol for Dental Providers and Dental Departments inside Hospitals and polyclinics.- Auditing Dental Claims and building audit cases to catch abuse and fraud.- Developing corrective measures for Dental Providers and for Bupa to comply with the medical guidelines, regulations, and to improve dental practice.- Compensating the losses accumulated by Abuse and Fraud.- Indirect Savings Projects.- Identifying system gaps in pre-authorization and claims.Key Achievements/Projects- Implemented HRM Dental rules in Bupa pre-authorization system in 2016 and achieving huge annual savings.- Compensating the losses of millions of riyals from fraudulent dental providers. (Cash Back Compensation and indirect savings projects)- Built Audit cases on major dental providers in Bupa Arabia network across the kingdom.- Created a team for Dental Audit as a division of Medical Audit department.- Worked on digitization and system automation projects with cross functional departments.

Key Achievements/Projects- Implementing Dental Protocol in all Dental providers within Bupa Network.- Was able to build the first audit case within the first 3 months of joining Bupa, against one of the biggest Dental Chains with an impact of 2M SR.- Identified the gaps in Bupa system and developed project initiation documents to implement Dental Rules and to automate them (HRM).- Achieved monthly savings as a compensation of Dental abuse and fraud cases. (Cash Back Compensation and indirect savings projects)

- Had a responsibility of a GP clinic and managed to over-achieve a 50K SAR target per month.- Built a relation with Dental Laps and Dental Materials suppliers.- Managed to balance between insurance and cash patients to deliver the best experience to all patients equally.- Supervised intern Senior Dentistry students and trained them to merge in the market.

- Had an internship program to practice all Dental specialties within MSA, Qasr AlAiny, and Al Azhar Hospital.- Duties: Oral Surgery – Periodontal Surgery – Operative – Removable Prothesis – Crown and Bridges – Fixed Prothesis – Paedodontics – Endodontics – Comprehensive Dental Treatment.

- Started as an assistant with Dr. Alaa private clinic during last year in college and during internship year to improve my skills and to practice cosmetic dentistry.